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PEDIATRICS Vol. 102 No. 1 Supplement July 1998, pp. 197-200

Reinventing a Specialty: How Pediatrics Survived Its Own Success

Jeffrey P. Baker

From Duke Children's Primary Care, Durham, North Carolina.

The first 300 words of the full text of this article appear below.

    INTRODUCTION

The first issue of Pediatrics appeared in 1948, a moment of history at which the prospects for pediatric science had rarely seemed brighter. The greatest accomplishments in child health of the early twentieth century had been for the most part preventive. Infant mortality had declined substantially thanks to maternal education campaigns, widespread pasteurization, and overall improved living standards. Now scientific pediatrics appeared ready to launch its own revolution.1 Penicillin and the antibiotics, hormonal therapies, oxygen for premature infants---all exemplified a newfound power of the pediatrician to treat, and even cure, disease. The message was not lost on the public. Some of the most powerful images of the United States during the 1950s were the pictures of the "polio pioneers," the long lines of American schoolchildren waiting voluntarily for a chance to receive the Salk vaccine. Pediatric leaders may have winced at Jonas Salk's use of television and radio to announce the vaccine's success, but could not have helped but take satisfaction from the response of a grateful public.2

Yet there was another side to this story. The commentaries and letters to the editor that appeared in Pediatrics during the same years reveal a profession torn over its future. There was widespread concern that pediatrics could not last for long as a primary care specialty. The purpose of this article will be to examine editorials and commentaries to both illuminate this paradox and then trace how its resolution led to a redefinition of what it meant to be a pediatrician. My focus is on the years between 1955 and 1975, the critical years of the transformation.3,4

    MEDICINE'S MOST FRUSTRATING SPECIALTY

Letters to the editor of Pediatrics during the 1950s do indeed reveal a picture of boredom, exhaustion, and discontent. "Many pediatricians are running themselves ragged by routine work," asserted one Michigan practitioner, "neglecting their own wives and . . . [Full Text of this Article]